Provider Demographics
NPI:1669584819
Name:HARDING, MARK A (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:HARDING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:2ND FLOOR, CBO 2-3
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-541-0700
Mailing Address - Fax:513-541-2530
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SU. 315
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-541-0700
Practice Address - Fax:513-541-2530
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY414412086S0129X
OH899022086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100056850Medicaid
IN200870910OtherIN MEDICAID
IN200870910AMedicaid
OHP00469075OtherRAIL ROAD MEDICARE
KY7100020200OtherKY MEDICAID
KY7100020200Medicaid
OH2779542Medicaid
KYP00689755OtherRAILROAD MEDICARE KY
KYP00689755Medicare PIN
KY7100020200OtherKY MEDICAID
KY7100020200Medicaid
OHP00469075OtherRAIL ROAD MEDICARE
IN200870910AMedicaid